Impact of Combination Antiretroviral Treatment on Liver Metabolic Health in HIV-Infected Persons

被引:8
作者
Bialy, Michal [1 ]
Czarnecki, Marcin [1 ]
Inglot, Malgorzata [1 ]
机构
[1] Wroclaw Med Univ, Dept Infect Dis, Liver Dis & Acquired Immune Deficiencies, PL-51149 Wroclaw, Poland
来源
VIRUSES-BASEL | 2023年 / 15卷 / 12期
关键词
HIV; cART; ART; antiretroviral therapy; NAFLD; MAFLD; MASLD; NASH; MASH; steatohepatitis; weight gain; insulin resistance; review; TENOFOVIR DISOPROXIL FUMARATE; INITIAL TREATMENT; DOUBLE-BLIND; ALAFENAMIDE; DISEASE; EMTRICITABINE; THERAPY; SAFETY; ADULTS; MULTICENTER;
D O I
10.3390/v15122432
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
In the last three decades, there has been a considerable improvement in human immunodeficiency virus (HIV) therapy. Acquired immunodeficiency syndrome (AIDS) is no longer a common cause of death for people living with HIV (PLWH) in developed countries, and co-infections with hepatitis viruses can be effectively managed. However, metabolic syndrome and metabolic dysfunction-associated steatotic liver disease (MASLD) are emerging threats these days, especially as the HIV-positive population gets older. The factors for MASLD development in PLWH are numerous, including non-specific (common for both HIV-positive and negative) and virus-specific. We focus on what is known for both, and in particular, on the burden of antiretroviral therapy (ART) for metabolic health and liver damage. We review data on contemporary drugs, including different groups and some particular agents in those groups. Among current ART regimens, the switch from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide fumarate (TAF) and particularly its combination with integrase inhibitors (INSTIs) appear to have the most significant impact on metabolic disturbances by increasing insulin resistance, which over the years promotes the evolution of the cascade leading to metabolic syndrome (MetS), MASLD, and eventually metabolic dysfunction-associated steatohepatitis (MASH).
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页数:14
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